van Minnen Branco S, van der Veen Albert J, van de Groes Sebastiaan A W, Verdonschot Nico J J, van Tienen Tony G
Orthopaedic Research Lab, Radboud University Medical Centre, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
ATRO Medical B.V., Liessentstraat 9A, 5405 AH, Uden, The Netherlands.
J Exp Orthop. 2022 Sep 7;9(1):91. doi: 10.1186/s40634-022-00531-6.
The aim of this study was to determine whether a flexible medial meniscus prosthesis is more capable of sharing loads with the direct tibiofemoral cartilage contact than the stiffer first-generation prosthesis. Additionally, the effect of the prosthesis on the tibial pressure distribution after total meniscectomy was investigated.
In an artificial knee joint, the relative amounts of load transferred through both meniscus prostheses and the direct tibiofemoral contact were assessed with pressure-sensitive sensors. Additionally, six cadaveric knee joints were loaded in a physiological environment. Tibial contact pressures were measured with an intact native meniscus, after total meniscectomy and after implantation of the second-generation meniscus prosthesis.
Whereas the first generation of the meniscus prosthesis transferred virtually all the load from femur to tibia, the second-generation prosthesis allowed for load sharing with the direct tibiofemoral contact. No differences in load sharing were found between the native meniscus and the second-generation meniscus prosthesis. The prosthesis decreased peak and mean pressures on the medial tibial cartilage compared to meniscectomy. No significant differences in pressure were found between the native meniscus and the meniscus prosthesis.
The second-generation meniscus prosthesis presented in this study can share loads with the direct tibiofemoral contact, a characteristic that the first-generation prosthesis did not have. The flexible meniscus prosthesis significantly reduces the contact pressures on the medial tibial plateau after total meniscectomy. Although the biomechanical performance of the native meniscus could not be reproduced completely, the meniscus prosthesis may have the potential to relieve post-meniscectomy pain symptoms.
本研究的目的是确定与第一代较硬的假体相比，柔性内侧半月板假体是否更能与胫股直接软骨接触分担负荷。此外，还研究了假体在全半月板切除术后对胫骨压力分布的影响。
在人工膝关节中，使用压敏传感器评估通过两种半月板假体和胫股直接接触传递的相对负荷量。此外，在生理环境中对六个尸体膝关节进行加载。在完整的天然半月板、全半月板切除术后以及植入第二代半月板假体后，测量胫骨接触压力。
第一代半月板假体几乎将所有负荷从股骨传递至胫骨，而第二代假体则允许与胫股直接接触分担负荷。天然半月板与第二代半月板假体之间在负荷分担方面未发现差异。与半月板切除术相比，假体降低了内侧胫骨软骨上的峰值压力和平均压力。天然半月板与半月板假体之间在压力方面未发现显著差异。
本研究中展示的第二代半月板假体能够与胫股直接接触分担负荷，这是第一代假体所不具备的特性。柔性半月板假体在全半月板切除术后显著降低了内侧胫骨平台的接触压力。尽管天然半月板的生物力学性能无法完全重现，但半月板假体可能具有缓解半月板切除术后疼痛症状的潜力。
